Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 1;4(3):216-9.
doi: 10.1177/2150131912465314. Epub 2012 Nov 4.

Primary care physicians' concerns may affect adolescents' access to intrauterine contraception

Susan E Rubin  1 , Giselle Campos, Susan Markens
Affiliations

Primary care physicians' concerns may affect adolescents' access to intrauterine contraception

Susan E Rubin et al. J Prim Care Community Health. .

Abstract

Purpose: Although the intrauterine device (IUD) may be safely used in adolescents, few US adolescents use IUDs. Increasing IUD use in adolescents can decrease pregnancy rates. Primary care providers' clinical practices many be one of the many barriers to increasing adolescents access to IUDs. We explored primary care physicians' (PCPs) approaches to contraception counseling with adolescents, focusing on their views about who would be appropriate IUD candidates.

Methods: Phone interviews were conducted with 28 urban family physicians, pediatricians, and obstetrician-gynecologists. Using standard qualitative techniques, we developed coding template and applied codes.

Results: Most respondents have a patient-centered general contraceptive counseling approach. However, when considering IUDs many PCPs describe more paternalistic counseling. For example, although many respondents believe adolescents' primary concern is pregnancy prevention, many PCPs prioritize sexually transmitted infection (STI) prevention and thus would not offer an IUD. Attributes PCPs associate with an appropriate IUD candidate include responsibility, reliability, maturity, and monogamy.

Conclusion: Our findings suggest that when considering IUDs for adolescents some PCPs' subjective assessment of adolescent sexual behavior, attitudes about STI risk factors and use of overly restrictive IUD eligibility criteria impede adolescent's IUD access. Education around best practices may be insufficient to counterbalance attitudes concerning adolescent sexuality and STI risk; there is also a need to identify and discuss PCPs potential biases or assumptions affecting contraception counseling.

Keywords: adolescents; birth control; contraception counseling; intrauterine contraception; intrauterine device; primary care; qualitative research.

PubMed Disclaimer

References

    1. Ventura SJ, Curtin SC, Abma JC, Henshaw SK. Estimated pregnancy rates and rate of pregnancy outcomes for the United States, 1990-2008. Natl Vital Stat Rep. 2012;60(7):1–21. - PubMed
    1. Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366:1998–2007. - PubMed
    1. American College of Obstetricians and Gynecologists . Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Jul, 2011. Practice Bulletin No. 121. - PubMed
    1. Centers for Disease Control and Prevention U.S. medical eligibility criteria for contraceptive use, 2010. MMWR Early Release. 2010;59:88.
    1. American College of Obstetricians and Gynecologists Adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2012;120:983–988. Committee Opinion 539. - PubMed

Publication types

MeSH terms